Chandrima Chatterjee

Google Hangout #5 Recap: Creating a wellness society through nutrient flows

On March 21st, Ashoka Changemakers hosted a game-changing Google+ Hangout discussion on how to creating a wellness society through nutrient flows. The fifth conversation included a diverse panel of participants that all tackled health from a unique perspective. The goal? To have them come together at the same table – or in our case, the same Hangout:

  • David Aylward, Senior Adviser, Global Health and Technology at Ashoka
  • Chloe de Roos Feinberg, Knowledge Manager for Health, Innovation, and Business Models at Ashoka Changemakers
  • James Militzer, Editor of NextBillion Health Care
  • Lisa Smith, Research Associate with the William Davidson Institute (WDI) at the University of Michigan
  • Marzena Zukowska, Moderator, Media Manager at Ashoka Changemakers

Check out a recap of the discussion below:

Q: Marzena – What is the gravest health issue the world is facing?

Chloe: Inequality in healthcare: access to information and resources, the inability to seek out healthcare and receive it. If you lack information, empowerment and access, or if the systems around you are highly inefficient, then you are at a disadvantage. That gap between those with that access and those without is growing.

James: Non-communicable diseases are coming to forefront more and more. And even more so, mental health issues, such as depression, will soon surpass non-communicable diseases (like heart disease) globally. The broad picture shows that this is an area in need of more focus. Substance abuse, which is an aspect of mental health issues, takes a lot out of lives, families and the economy. However, there are innovations out there that promise to help.

Lisa: Non-communicable diseases and infectious diseases create a double burden in low-income countries. Access to medicine, health technologies and information asymmetries are all issues to deal with. This dual burden of disease will lead us to think about issues of access. It’s important to understand the dynamics between supply side and demand side: patient knowledge of product (demand) and drug store owners/pharmacists (supply) both need to be educated in the knowledge of innovations. The Zinc-conundrum shows clearly what happens when the market is poorly understood and educated before introducing a new therapy. Zinc is successful in treating diarrheal diseases but the uptake is poor. Interventions to increase uptake and market the product better are required.

David: The biggest failure is our global health system. Look at Western medicine – we’re spending enormous amount of money, nearly 20% of our GNP towards health care, yet we remain 19th in the world by most categories of outcomes. Four billion people who we can call the base of the pyramid lack access to health in the most basic forms. The global disease burden is changing from trauma and infectious disease to chronic disease, driven in great part by behavior, of which a huge part is diet. Two billion people are living with ‘hidden hunger’. One billion are overeating. The system is not working and is being overwhelmed by a flood of other diseases. The number one cause of days lost for illness in the developing world and in the middle income world, is depression. The bottom line is we are not treating people holistically and ignoring overall wellness and vitality. Instead we are focusing on sick care. We are doing it poorly.

Q: Marzena – How could focusing on nutrients trigger a wellness economy?

David: The 1,000 days from the start of a woman’s pregnancy until her child’s 2nd birthday offer a unique window of opportunity to shape healthier and more prosperous futures. If we get it right during that 1000 days, good things happen. Focuses there should include: breast milk feeding which directly results in a stronger immune system. Without it, the child is 14 times more likely to die of pneumonia, 10 times more likely to die of diarrhea. People would choose nutrient rich foods if they have access to it.

James: The challenge often involves behavioral changes. How about addressing the problems of taste versus nutrition. Often tastier foods (produced by massive food manufacturers) are not nutritional but people cannot resist.

Chloe: Also, changing the environments in which the individual is acting has significant impact on behavior. So the question become how do you shift the environments people are in to nudge them into making the right decision.

Lisa: The ecosystem and enabling environment is very important. How do we nudge the global and local market to create changes in people’s environments. Think about it from a supply side.

David: We have ended up with a group of people (Ministry of Health), Family Welfare, Agriculture, Sanitation, etc. We know that they need to work in concert. How do we integrate and tear down the walls between the different groups? It’s a lot easier to focus on the demand side (moms, teachers, etc) than to organize those groups.

James: Sounds like a lot of business potential you are talking about, so why haven’t they happened yet?

David: There’s always an area in grocery stores devoted to nutritional supplements. There is a demand for healthy things. What we lack however, is that we don’t’ know how to measure whether you’re fully nourished or not. How do we do a full spectrum measurement of nutrition? Measuring nutritional outcome by the consumer might lead to changes in food purchasing and eating behavior. Given the current digital technology and price path, within 5-10 years, you could get down to an affordable wellness device.


Marzena notes the importance of mobile devices in this new frontier of a nutrient economy. Using human health indices. Conscious innovation. Nutrient rich food is profitable.

David: These are areas where the government spends a lot of money but we haven’t set the existing systems and infrastructure up to integrate it, make it accountable, have research involved. We are at an interesting tipping point. Chage is almost inevitable.

Marzena: What about scaling? How would the relationship between social entrepreneurs and government look? What about between social entrepreneurs and big business?

David: Metrics to measure outcomes. Who cares about the overall well-being of people – employers! Because it leads to more productivity.

Marzena: What about the role of small holder farmers – getting products to consumers, not big food biz.

Chloe: Access to finance is difficult for agriculture (it is still a risky biz). We currently reward bad behavior because of overall cost reductions and need to bring the other factors into the fold.

David: There is a growing recognition among multinationals that they need to address issues of sustainability and product quality; wellness of farmers needs to be addressed too. Small holder farmers are kind of like employees. We call it a nutrient economy so that people at every stage of food production process measure in nutrients. We should reward farmers for nutrient rich soil – not quantity. We should measure acreage and food by nutrients.

James: It seems what we are doing is trying to get people to do what doesn’t come naturally to them. How do we address that?

Chloe: Provide a service to re-teach people what to do with food – cooking is a lost art. An innovation would combine product with services like cooking classes. We won’t see the drastic change, we’ll see this happening from the fringes.

David: If you’re a Minister of Health, Finance, etc, and project in heart disease and diabetes, think of overall costs. In India, 47% of your 2 –year-olds are growth-stunted. The genetics of those children leave them more susceptible to diabetes and heart disease now too. Therefore, in the long-run, economic productivity of the county goes down and the health burden goes up. At some point, addressing this will be unavoidable. This is a crisis. People in the US don’t get it yet but they will…

You can view the Hangout here:

Editor’s Note: This Nutrients for All Google+ Hangout was co-hosted with NextBillion Health Care as part of Ashoka Changemakers Health Ideas Week. Don’t miss a recap Storify of the Twitter discussion (#SocEntChat) we had earlier in the week.

Health Care
nutrition, public health